Level B

Level A

collaborate with the provider in managing the panel, and play a major role providing preventive services, and services to chronically ill patients such as self-management coaching, or follow-up phone calls.

What Do Your Choices Mean?

If you score in Level D in any area, your practice is just getting started and may want to review our resources page to help you prepare for the key changes described in that section of the guide.

If you score in Level C in any area, your practice is in the early stages of change and can benefit from the action steps and resources in that section of the guide.

If you score in Level B in any area, your practice has implemented basic changes and can build upon your success with the action steps and resources in that section of the guide.

If you scored in Level A in any area, your practice has achieved most or all of the important changes required. Congratulations! You can still use the actions steps and resources in that section of the guide to find new ways to improve.

Why is it important to rethink the role of the MA?

Medical assistants (MAs) are essential staff at most primary care practices. They keep patients flowing through the clinic and ensure that providers have the information and tools they need. But MAs are often capable of doing much more. As one of the first points of contact for patients, they often have a deep knowledge of patients’ personal and medical histories. Most are also adept at using the electronic health record (EHR), and with proper training, they can play major roles in preventive care, coaching patients, and population management.

How should the role of the MA change?

Traditionally, MA activities have been limited to things like rooming patients, taking vitals, setting up equipment, and helping with paperwork. In most LEAP sites, MAs are responsible for a much broader range of activities, including:

Helping with pre-visit planning

Answering phones, triaging calls, and generally serving as a primary point of contact for patients

What do we gain by making these changes?

The benefits of encouraging MAs to take on more responsibilities include:

Better customer service

Better performance metrics

More effective patient outreach

Increased efficiency because providers and other specialized staff can focus on tasks that require their level of expertise

Added capacity if MA role expansion allows other team members to independently take on clinician work (RNs, pharmacists, behavioral health specialists)

Webinar: Enhancing the role of the MA

Read more

Learn about expanding MA roles in this webinar featuring LEAP sites. This is part of a great series of webinars on Advancing Team-based Care organized by Community Health Center, Inc. Slides are also available at http://weitzmaninstitute.org/NCA

High Plains Community Health Center Transformation Story

Read more

Learn how one LEAP site has expanded the MA role. High Plains CHC in Colorado has 3 Patient Facilitators per care team, who rotate front and back office tasks, coordinate referrals, do immunizations, and bring everything to the patient into one room during visits.

Select a model.

Explore the different models available among the tools and select one—or combine them—to ensure the role fits your practices culture and resources.

Learn how one LEAP site has expanded the MA role. High Plains CHC in Colorado has three Patient Facilitators per care team who rotate front and back office tasks, coordinate referrals, do immunizations, and bring everything necessary to the patient into one room during visits.

Union Health Center—Pioneering the Ambulatory Intensive Caring Unit

Learn how one LEAP site has expanded the MA role. Union Health Center in New York City has a dedicated Patient Care Assistant for each provider. PCAs provide patient education, perform outreach using chronic disease registries, and rotate front desk duties.

"Share the Care" Assessment of Team Roles and Tasks

This is an example of a planning tool, to assess who is currently doing what tasks in your practice and then who should be doing each task, based on how we learned that LEAP sites define clear roles and responsibilities. Task distribution will vary from practice to practice, but the tool is in the discussion about roles that this worksheet can stimulate. Your practice may be able to redestribute tasks in a way that better fits your workforce and patient needs.

Scribing Model: 2 Clinical Assistants with 1 provider

Learn how one LEAP site developed a developed a scribing model, by watching this video. In this model at Family Care Network, a provider has two flow staff (MAs or LPNs), called Clinical Assistants, who are trained to scribe during the patient visit and work with patients to ensure they understand information from the provider. This enables the provider to spend less time on documentation and less time with each patient per visit, while providing patients with high quality care.

Research your state’s policies on MA scope of work to ensure that your new model complies with state regulations and that your MAs are doing all their “license” allows. This is an action step that may apply to other team members, but we found that MA scope of practice and certification policies appeared more variable across states and had a bigger impact on MA roles than was true for other roles.

View Resources

Role features

State Scope of Practice Laws for Medical Assistants

Get information about MA scope of practice in your state, on the website of the American Association of Medical Assistants (AAMA).

Saving Time and Improving Efficiency with Team Documentation

This article clearly articulates how well-trained clinical assistants (MAs, LPNs, or RNs) can help improve the practice with team documentation (their preferred word for "scribing" because the role involves contributing to clinical care, not just recording the visit). Hopkins K, Sinsky CA. Team-based care: saving time and improving efficiency.Fam Pract Manag. 2014 Nov-Dec;21(6):23-9. PubMed PMID: 25403048.

Excellent MAs need to have a range of skills, not all of which are necessarily provided through MA training courses. Many LEAP sites hire for attitude and train for clinical knowledge and skills. Critical skills include a strong customer service orientation, an eye for detail, and the ability to work well on a team. It often helps to hire staff from the cultures and communities of patients that the clinic serves.

View Resources

Role features

Patient Facilitator Job Description

Here is the job description of an MA role, patient facilitator, at one LEAP site (High Plains). In Colorado, MAs do not need to be certified, so this site has found success in hiring people with customer service and interpersonal skills without having any MA certification or experience. The practice provides robust training on the clinical skills to meet those job responsibilities (see Step 5).

Care Team Medical Assistant Job Description

Here is the job description of the Care Team MA at one LEAP site, Sebastopol/West County, reflecting the MA's role in managing patient flow, leading care team huddles, and performing population management during sanctioned time each week.

Medical Assistant Externship Clinical Protocol

West County/Sebastopol uses the MA extern program at a nearby college to assess fit of potential care team MAs. Externs who thrive in the team model are hired on full time and this is a very successful mechanism to sustain good MAs.

Patient Care Assistant (Medical Assistant) Job Description

Here is the job description of an MA role, Patient Care Assistant, at one LEAP site. At this site, Union Health Center, MAs take an active role in patient education and can be promoted to Health Coach (see step 6)

MAs often go through a formal training and certification process. However, many LEAP sites hired people with little to no health care experience and trained them to be an MA. Regardless, for MAs to take on different tasks, they will often need additional training in motivational interviewing, quality improvement, leadership, and other areas. New MAs sometimes spend up to six months training. The resources in this section will help you explore different training options for your MAs.

View Resources

Staff training

Care Team Medical Assistant Training Curriculum

See what one LEAP site has developed as a training curriculum for an expanded MA role. Training includes what it means to be in charge of patient flow, how to lead care team huddles, how to perform population management for their patient panel, and communication skills for interviewing patients and working with team members. They developed protocol for all responsibilities and workflows, to support MAs as they work at the top of their license.

Link to standing orders

Care Team MA report card

At LEAP site West County Health Centers, care team MAs receive "report cards" that show their progress in meeting the preventive care needs of their patients. The MA supervisor (an MA who has been promoted to oversee all MAs at that site) reviews the report card with each MA to discuss what is working well and what might be improved to achieve population management targets.

Supporting MA role expansion

In this video, learn how one LEAP site developed supports for MAs to function in an expanded role. West County empowers MA's by providing thorough orientation to the role, training, standing orders, and having MA role-specific metrics.

Patient Facilitator Competency Checklist

See the Competency checklist used by one LEAP site to ensure Patient Facilitators (MAs) have demonstrated competency over the course of their first six months of training. This site also closes the clinic for 1 hour every week for ongoing training and refreshers.

The MA role is an entry level position that often attracts smart, dedicated individuals. Providing a clear career ladder and/or opportunities for growth and skill development helps minimize turnover, improves morale, and rewards high performers.

View Resources

Video

Union Health Center Career Ladder

Watch this video about the career ladder at LEAP site Union Health Center. MA’s can move into more advanced roles by showing strong communication skills, critical thinking, and collaboration. The first step up is becoming a Health Coach, supporting patients with chronic conditions in goal setting and self-management support. Health Coaches can then be promoted to floor coordinator, to manage patient flow for a care team, schedule provider time, and assist MAs

Medical Assistant Pay Scales

See the compensation that one LEAP site provides to MAs as they expand their skillset and take on additional responsibilities with the organization. MAs can work in the lab, imaging, or move into clinic management positions. Promoted MAs have served important roles in opening new practices as the organization rapidly expands access in the community.

Learn how one LEAP site has expanded the MA role. High Plains CHC in Colorado has three Patient Facilitators per care team who rotate front and back office tasks, coordinate referrals, do immunizations, and bring everything necessary to the patient into one room during visits.

Saving Time and Improving Efficiency with Team Documentation

This article clearly articulates how well-trained clinical assistants (MAs, LPNs, or RNs) can help improve the practice with team documentation (their preferred word for "scribing" because the role involves contributing to clinical care, not just recording the visit). Hopkins K, Sinsky CA. Team-based care: saving time and improving efficiency.Fam Pract Manag. 2014 Nov-Dec;21(6):23-9. PubMed PMID: 25403048.

Webinar and power point presentations

Webinar and power point presentations

Webinar: Enhancing the role of the MA

Learn about expanding MA roles in this webinar featuring LEAP sites. This is part of a great series of webinars on Advancing Team-based Care organized by Community Health Center, Inc. Slides are also available at http://weitzmaninstitute.org/NCA

Video

Video

High Plains Community Health Center Transformation Story

Learn how one LEAP site has expanded the MA role. High Plains CHC in Colorado has 3 Patient Facilitators per care team, who rotate front and back office tasks, coordinate referrals, do immunizations, and bring everything to the patient into one room during visits.

Scribing Model: 2 Clinical Assistants with 1 provider

Learn how one LEAP site developed a developed a scribing model, by watching this video. In this model at Family Care Network, a provider has two flow staff (MAs or LPNs), called Clinical Assistants, who are trained to scribe during the patient visit and work with patients to ensure they understand information from the provider. This enables the provider to spend less time on documentation and less time with each patient per visit, while providing patients with high quality care.

Supporting MA role expansion

In this video, learn how one LEAP site developed supports for MAs to function in an expanded role. West County empowers MA's by providing thorough orientation to the role, training, standing orders, and having MA role-specific metrics.

Union Health Center Career Ladder

Watch this video about the career ladder at LEAP site Union Health Center. MA’s can move into more advanced roles by showing strong communication skills, critical thinking, and collaboration. The first step up is becoming a Health Coach, supporting patients with chronic conditions in goal setting and self-management support. Health Coaches can then be promoted to floor coordinator, to manage patient flow for a care team, schedule provider time, and assist MAs

Case summariesVignettes, profiles and testimonial videos

Case summaries

Union Health Center—Pioneering the Ambulatory Intensive Caring Unit

Learn how one LEAP site has expanded the MA role. Union Health Center in New York City has a dedicated Patient Care Assistant for each provider. PCAs provide patient education, perform outreach using chronic disease registries, and rotate front desk duties.

Role featuresJob descriptions, career ladders and other HR materials

Role features

"Share the Care" Assessment of Team Roles and Tasks

This is an example of a planning tool, to assess who is currently doing what tasks in your practice and then who should be doing each task, based on how we learned that LEAP sites define clear roles and responsibilities. Task distribution will vary from practice to practice, but the tool is in the discussion about roles that this worksheet can stimulate. Your practice may be able to redestribute tasks in a way that better fits your workforce and patient needs.

MAs in California: Legal Scope of Practice

Patient Facilitator Job Description

Here is the job description of an MA role, patient facilitator, at one LEAP site (High Plains). In Colorado, MAs do not need to be certified, so this site has found success in hiring people with customer service and interpersonal skills without having any MA certification or experience. The practice provides robust training on the clinical skills to meet those job responsibilities (see Step 5).

Care Team Medical Assistant Job Description

Here is the job description of the Care Team MA at one LEAP site, Sebastopol/West County, reflecting the MA's role in managing patient flow, leading care team huddles, and performing population management during sanctioned time each week.

Patient Care Assistant (Medical Assistant) Job Description

Here is the job description of an MA role, Patient Care Assistant, at one LEAP site. At this site, Union Health Center, MAs take an active role in patient education and can be promoted to Health Coach (see step 6)

Care Team MA report card

At LEAP site West County Health Centers, care team MAs receive "report cards" that show their progress in meeting the preventive care needs of their patients. The MA supervisor (an MA who has been promoted to oversee all MAs at that site) reviews the report card with each MA to discuss what is working well and what might be improved to achieve population management targets.

Medical Assistant Pay Scales

See the compensation that one LEAP site provides to MAs as they expand their skillset and take on additional responsibilities with the organization. MAs can work in the lab, imaging, or move into clinic management positions. Promoted MAs have served important roles in opening new practices as the organization rapidly expands access in the community.

Introduction to Care Team Roles and Understanding the MA Scope of Practice

Medical Assistant Externship Clinical Protocol

West County/Sebastopol uses the MA extern program at a nearby college to assess fit of potential care team MAs. Externs who thrive in the team model are hired on full time and this is a very successful mechanism to sustain good MAs.

Care Team Medical Assistant Training Curriculum

See what one LEAP site has developed as a training curriculum for an expanded MA role. Training includes what it means to be in charge of patient flow, how to lead care team huddles, how to perform population management for their patient panel, and communication skills for interviewing patients and working with team members. They developed protocol for all responsibilities and workflows, to support MAs as they work at the top of their license.

Patient Facilitator Competency Checklist

See the Competency checklist used by one LEAP site to ensure Patient Facilitators (MAs) have demonstrated competency over the course of their first six months of training. This site also closes the clinic for 1 hour every week for ongoing training and refreshers.

Link to standing orders

If you have a question about the improvements, action steps, or tools & resources in this module please let us know. We're here to help. And if we can't answer your question, we can probably connect you with someone who can.